Ebola death toll rises to 930, as outbreak spreads at record pace
Africa Centres for Disease Control and Prevention and partners plan trial of two existing jabs
The Ebola outbreak in the Democratic Republic of Congo has killed at least 930 people, the country’s health ministry said on Monday, adding urgency to efforts to find a vaccine to counter the disease’s rapid spread.
The Africa Centres for Disease Control and Prevention (CDC) is developing a possible trial on whether the Bundibugyo pathogen driving the crisis can be combated by jabs against other ebolavirus species.
The Ebola outbreak is the fastest-growing ever by some measures, more than two months after the World Health Organization declared it a public health emergency of international concern. The WHO said last week that more than 80 per cent of new cases were not on known contact lists, suggesting that track and trace protocols were missing many chains of transmission.
“When you start seeing cases with no known contact, that’s a big red flag because it means there are a lot of cases out there you don’t know about,” said Paul Hunter, professor in medicine at the University of East Anglia. “The concern clearly is how long it will stay in Congo and whether it will start spreading to surrounding countries: the bigger it gets the more likely that is.”
DR Congo authorities recorded 37 Ebola deaths in the previous 24 hours, one of the highest recent daily totals, the health ministry said. Last week, the ministry reported that the disease had reached two new provinces and it has now been found in five in the country’s east, where it remains centred on the Ituri region.
The sustained surge in case numbers to 2,365 by Sunday, including 20 in Uganda and one in France, has dismayed the WHO. Last week its director-general Tedros Adhanom Ghebreyesus conceded that health authorities were struggling with an outbreak that was “continuing to outpace the response”.
The deadliest outbreak of Ebola, which is transmitted between humans primarily by direct contact with bodily fluids, killed more than 11,300 people in three West African countries in 2014-16. It led to the development of the Ervebo vaccine by Merck, which is known as MSD outside North America, against the Zaire ebolavirus species responsible.
The Bundibugyo pathogen in the current DR Congo Ebola crisis has no vaccine or treatment. International health organisations including the Coalition for Epidemic Preparedness Innovations are investing in a quest to find a viable new jab for it within months.
The Africa CDC and partners are planning a trial of a two-vaccine combination on frontline health workers in eastern Congo, the health body has said. The first dose would be of the Ervebo vaccine, while the second would be an experimental jab against the Sudan ebolavirus species. The proposal is expected to be submitted as soon as Tuesday for approval by the Africa CDC’s executive committee.
The approach would have the practical advantage that Ervebo already has regulatory approval. The experimental vaccine, developed by the international biomedical research non-profit IAVI, was used during a Sudan pathogen outbreak in Uganda last year.
Efforts to control the DR Congo outbreak have been further undermined by suspicion among local people about the cause of the disease and the motives of outsiders. More than a dozen health facilities have been attacked, some after refusing to release bodies over concern about the further spread of the virus through traditional funerals. One facility was attacked last week in Bunia, the capital of Ituri province, according to the WHO.